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How to Keep a Bladder Diary

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Overactive bladder (OAB) is an umbrella term for several urinary symptoms. The most common symptom is a sudden urge to urinate that you can’t control. Other symptoms include leaking urine, frequent urination, and waking up at night to urinate. 

OAB is a common condition, affecting as many as 40% of women and 30% of men in the United States. It can usually be managed with lifestyle changes, prescription medications, botulinum toxin (Botox) treatments, nerve stimulation, and, in severe cases, surgery. 

Whether you’ve already been diagnosed with OAB or you suspect you have it, you may want to consider keeping a bladder diary. This can give you clues about what’s behind your OAB symptoms and even help you manage them. 

“The bottom line is, these are very easy to do,” says Howard Goldman, MD, a urologist at Cleveland Clinic. “They don’t cost anything, there’s no risk, and many of the guidelines on how to treat overactive bladder suggest that a keeping a diary before starting treatment can be very helpful.”

There are several reasons you may want to start a bladder diary.

To gather data for yourself: “If you think something might be going on, keeping a bladder diary could be really helpful just to see how often you’re really going to the bathroom and when you leak urine,” says Margaret Mueller, MD, a urogynecologist at Northwestern Medicine in Chicago. 

That said, Mueller notes that women in particular tend to think that they urinate too frequently because “their bladder is interfering with their being able to do 100 million things in a day.” In reality, she says they’re often within the range of normal. A bladder diary can show this and give you reassurance.

To take to your health care provider: If you decide to see your health care provider about your symptoms, it’s helpful to have a bladder diary completed. For instance, keeping track of how much you’re urinating can give your provider a much better sense of how much your bladder can hold and how much you’re actually going to the bathroom. “We have patients who think they’re going all the time, but you see their diary and they’re only going five times,” says Goldman. “It’s a big difference if someone’s holding just 6 ounces in their bladder versus 15 ounces.”

To pinpoint behaviors that you can change: Maybe you’re having bothersome symptoms like having to go to the bathroom too often or needing to run to get to the bathroom in time. Goldman says a bladder diary may show you some behaviors that you can change on your own before you even go to the doctor. 

For example, you might see that you’re drinking a lot right before you go to bed or consuming more Diet Cokes a day than you thought. “Sometimes, part of the OAB problem is that someone may be taking in too much fluid or too much caffeine, which may be an underlying contributing factor,” Goldman says.

When your health care provider requests it: Goldman has his patients keep a bladder diary when he first sees them. “It’s most important right at the start to get some idea of what’s going on,” he says.

Both Mueller and Goldman also sometimes have their patients keep a bladder diary when they start a new treatment or to measure their response to treatment. “There are some therapies where we may do a trial. In those cases, we may do a diary beforehand and then during the therapy to get a sense of how much it’s helping,” Goldman says.

Mueller uses a bladder diary to see how often her patients leak urine with a strong urge to go to the bathroom and how often they leak urine with coughing, sneezing, etc. She also wants to see how often they’re urinating. This combination helps her determine what treatment may be needed.

“Let’s say there’s no leakage, but they’re going to the bathroom every 30 minutes,” Mueller says. “You might be able to do an intervention called timed voiding, which is basically retraining the bladder. This has been shown to be effective.” In this example, you would try to stretch out going to the bathroom to an hour instead of 30 minutes. Gradually, you would keep adding another 30 minutes until you’re urinating every 2 hours.

When you get up multiple times during the night: A bladder diary is important for people who urinate often at night “because we can see if they’re putting out more urine at night than they should,” says Goldman. Typically, you should urinate less than a third of your total volume of urine at night, he explains. If you’re voiding more than that, this could indicate other medical problems that are causing your body to put out more fluid in the evening.

One of the more common causes of making too much urine at night, known as nocturnal polyuria, is obstructive sleep apnea. “When you have obstructive sleep apnea, you make less antidiuretic hormone because the body thinks it’s daytime and makes urine like normal,” says Mueller. If someone has risk factors for sleep apnea such as snoring, overweight, or obesity, “we’ll typically have them referred for a sleep study to see if that might be part of the picture,” she says. “The benefit is that sleep apnea is reversible and getting treated for it can really reduce those bladder symptoms.”

Pick your tracking method. You can write your bladder diary in a notebook, download a template and print it out (Goldman recommends this one), or find an app for your phone. There are even companies that sell cups that measure your urine and automatically upload your volume to an app, according to Goldman. “Your average person probably doesn’t need to be that fancy though,” he says.

Keep the diary for 3 days. One day isn’t enough because things can change too much from day to day, Goldman says. “There have been studies that show that a 3-day diary isn’t much different than longer diaries, so 3 days is short enough to get a sense of what’s going on but long enough to give you an accurate idea,” he explains. 

Use 24-hour periods. Start tracking when you wake up in the morning. You don’t have to track for 3 days in a row, but you should do 24 hours at a time. For example, if you get up at 7 a.m. the first day, fill out your diary until 7 a.m. the next day.

Measure your urine. You’ll need a cup unless you have a collection device from your health care provider. A measuring cup is a good choice so you can see exactly how much you’ve passed. You’ll need to rinse the cup or collection device with water after every use. Be sure to measure and keep track of how much urine you pass both during the day and at night.

Use a bladder diary to track information and symptoms such as:

  • How much fluid you drink
  • How often you drink
  • How often you urinate
  • How much you urinate
  • How often you feel an urgent need to urinate
  • When and how much urine you leak, if applicable

Goldman stresses that it’s important to have your health care provider check everything out if you have OAB symptoms. “There’s everything now, from certain exercises to plenty of medications to Botox injections and pacemakers,” he says. “We can do all kinds of things, so OAB is not something people should have to live with.”



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Walmart Is Selling a $300 Power Tower for Just $128, and Shoppers Say It's 'Surprisingly Sturdy'

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Men’s Journal aims to feature only the best products and services.  If you buy something via one of our links, we may earn a commission.

When building a home gym, it’s easy to get overwhelmed by all the equipment options, especially when you’re working with limited space and a tight budget. But when you focus on versatile gear and hunt for deals, creating a useful setup is easily doable. Thankfully, Walmart has been slashing prices on a ton of fitness equipment, including its bestselling adjustable dumbbells and even a complete home gym system. Now, it’s reduced the price of a popular power tower by over $170, and it even ships for free.

The Pooboo Body Champ Multifunction Power Tower is on sale for $128, a 57% discount on its normal price of $300. This incredibly versatile workout station has earned nearly 250 five-star ratings from Walmart shoppers who’ve praised its “strong and sturdy” build and “quality fit and finish,” and it’s currently one of the top 5 bestselling models on the site.

Pooboo Body Champ Multifunction Power Tower, $128 (was $300) at Walmart

Courtesy of Walmart

Get It

Don’t let the brand’s bizarre name fool you—this power tower is a well-made piece of gym equipment. It features steel construction and is rated to hold up to 480 pounds (the tower itself weighs 66 pounds). A nearly 42-inch H-shaped base gives it excellent stability, so it won’t wobble or shake when you’re exercising, and anti-slip feet on the bottom keep it securely planted on the floor. It’s also adjustable (from 71.4 inches to 94 inches) to accommodate users of varying heights. And, once it’s set up, you can use it for a huge range of exercises, including dips, pull-ups, chin-ups, push-ups, vertical leg raises, knee raises, and more.

According to Walmart reviewers, the Pooboo Body Champ stands out for its solid build and usefulness. “It’s a surprisingly sturdy piece of equipment,” a shopper said. “Everything about this fitness tower is perfect. I originally purchased this with the intention of only doing pull-ups on it, but after quickly assembling the power tower, I came to realize just how versatile it is. It has cushions for knee and leg raises, it’s sturdy, and the perfect width for dips.” Another shopper agreed, saying, “This was a much-needed addition to my home gym.”

Related: A ‘Very Supportive’ Brooks Running Shoe With the ‘Perfect Balance of Comfort and Style’ Is Over $50 Off Right Now

“This thing is amazing and worth every penny,” said another, who added that it’s “easy to install and can hold a lot of weight.”

At just $128, this Pooboo power tower is a screaming deal, and it’s sure to get lots of use during your workouts. But this discount won’t last long, so grab one today before the price pumps back up.



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Alzheimer’s Drug May Save Lives Through ‘Suspended Animation’

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By Lindsay Brownell | Wyss Institute Communications | Harvard Gazette

Could buy patients more time to survive critical injuries and diseases, even when disaster strikes far from a hospital

Donepezil, an FDA-approved drug to treat Alzheimer’s, has the potential to be repurposed for use in emergency situations to prevent irreversible organ injury, according to researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University.

Using Donepezil (DPN), researchers report that they were able to put tadpoles of Xenopus laevis frogs into a hibernation-like torpor.

“Cooling a patient’s body down to slow its metabolic processes has long been used in medical settings to reduce injuries and long-term problems from severe conditions, but it can only currently be done in a well-resourced hospital,” said co-author Michael Super, director of immuno-materials at the Wyss Institute. “Achieving a similar state of ‘biostasis’ with an easily administered drug like DNP could potentially save millions of lives every year.”

This research, published Thursday in ACS Nano, was supported as part of the DARPA Biostasis Program, which funds projects that aim to extend the time for lifesaving medical treatment, often referred to as “the Golden Hour,” following traumatic injury or acute infection. The Wyss Institute has been a participant in the Biostasis Program since 2018, and has achieved several important milestones over the last few years.

Using a combination of predictive machine learning algorithms and animal models, the Wyss’ Biostasis team previously identified and tested existing drug compounds that had the potential to put living tissues into a state of suspended animation. Their first successful candidate, SNC80, significantly reduced oxygen consumption (a proxy for metabolism) in both a beating pig heart and in human organ chips, but is known to cause seizures when injected systemically.

In the new study, they once again turned to their algorithm to identify other compounds whose structures are similar to SNC80. Their top candidate was DNP, which has been approved since 1996 to treat Alzheimer’s.

Achieving a similar state of ‘biostasis’ with an easily administered drug like DNP could potentially save millions of lives every year.

–Michael Super

“Interestingly, clinical overdoses of DNP in patients suffering from Alzheimer’s disease have been associated with drowsiness and a reduced heart rate — symptoms that are torpor-like. However, this is the first study, to our knowledge, that focuses on leveraging those effects as the main clinical response, and not as side effects,” said the study’s first author, María Plaza Oliver, who was a postdoctoral fellow at the Wyss Institute when the work was conducted.

The team used X. laevis tadpoles to evaluate DNP’s effects on a whole living organism, and found that it successfully induced a torpor-like state that could be reversed when the drug was removed. The drug, however, did seem to cause some toxicity, and accumulated in all of the animals’ tissues. To solve that problem, the researchers encapsulated DNP inside lipid nanocarriers, and found that this both reduced toxicity and caused the drug to accumulate in the animals’ brain tissues. This is a promising result, as the central nervous system is known to mediate hibernation and torpor in other animals as well.

Although DNP has been shown to protect neurons from metabolic stress in models of Alzheimer’s disease, the team cautions that more work is needed to understand exactly how it causes torpor, as well as scale up production of the encapsulated DNP for use in larger animals and, potentially, humans.

“Donepezil has been used worldwide by patients for decades, so its properties and manufacturing methods are well-established. Lipid nanocarriers similar to the ones we used are also now approved for clinical use in other applications. This study demonstrates that an encapsulated version of the drug could potentially be used in the future to buy patients critical time to survive devastating injuries and diseases, and it could be easily formulated and produced at scale on a much shorter time scale than a new drug,” said senior author Donald Ingber, the Judah Folkman Professor of Vascular Biology at Harvard Medical School and Boston Children’s Hospital, and the Hansjörg Wyss Professor of Bioinspired Engineering at Harvard’s John A. Paulson School of Engineering and Applied Sciences.

This research was supported by DARPA under Cooperative Agreement Number W911NF-19-2-0027, the Margarita Salas postdoctoral grant co-funded by the Spanish Ministry of Universities, and the University of Castilla-La Mancha (NextGeneration EU UNI/551/2021).

This story is reprinted with permission from The Harvard Gazette.

***

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Can Stuff in Rosemary Extract Fight Cocaine Addiction?

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Researchers have discovered that an antioxidant found in rosemary extract can reduce intakes of cocaine by moderating the brain’s reward response, offering a new therapeutic target for treating addiction.

 

By Pat Harriman-UC Irvine

The study in the journal Neuron describes researchers’ focus on a region of the brain called the globus pallidus externus, which acts as a gatekeeper that regulates how we react to cocaine.

They discovered that within the GPe, parvalbumin-positive neurons are crucial in controlling the response to cocaine by changing the activity neurons releasing the pleasure molecule dopamine.

“There are currently no effective therapeutics for dependence on psychostimulants such as cocaine, which, along with opioids, represent a substantial health burden,” says corresponding author Kevin Beier, an associate professor of physiology and biophysics at the University of California, Irvine.

“Our study deepens our understanding of the basic brain mechanisms that increase vulnerability to substance use disorder-related outcomes and provides a foundation for the development of new interventions.”

Findings in mice revealed that globus pallidus externus parvalbumin-positive cells, which indirectly influence the release of dopamine, become more excitable after being exposed to cocaine. This caused a drop in the expression of certain proteins that encode membrane channels that usually help keep the globus pallidus cell activity in check. The researchers found that carnosic acid, an isolate of rosemary extract, selectively binds to the affected channels, providing an avenue to reduce response to the drug in a relatively specific fashion.

“Only a subset of individuals are vulnerable to developing a substance use disorder, but we cannot yet identify who they are. If globus pallidus cell activity can effectively predict response to cocaine, it could be used to measure likely responses and thus serve as a biomarker for the most vulnerable,” Beier says. “Furthermore, it’s possible that carnosic acid could be given to those at high risk to reduce the response to cocaine.”

The next steps in this research include thoroughly assessing negative side effects of carnosic acid and determining the ideal dosage and timing. The team is also interested in testing its efficacy in reducing the desire for other drugs and in developing more potent and targeted variants.

Scientists from the University of West Virginia and the University of Colorado participated in the study.

Support for this work came from the National Institutes of Health, One Mind, the Alzheimer’s Association, New Vision Research, BrightFocus Foundation, and the Brain & Behavior Research Foundation.

Source: UC Irvine

Previously Published on futurity.org with Creative Commons License

***

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